We teach femoral and forearm nerve blocks at EDE 2 and a bunch more nerve blocks at EDE 3. The forearm blocks are easier than the femoral block but the indication doesn’t come up as often. At EDE 2, we often get asked about the clinical scenarios in which we would use a forearm block. Here’s an example…

A 10 year old boy presented with a right pinky injury. It was bent backwards 3 days prior while playing tetherball. Here’s his X-ray.

So, it was angulated enough that it needed to be reduced. But digital blocks often don’t work well enough for proximal finger injuries. A decision was made to perform a POCUS-guided ulnar nerve block. The needle approach to just far field to the ulnar nerve is shown in this video.

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The block worked wonderfully! Dropped a pencil into the web space and reamed on the finger. Crack heard/felt when the finger was straightened. Zero pain! The only way in which the procedure bothered the child was that he could only use his left hand to play video games on his smart phone! We get that. After all, what is POCUS for procedures but a form of a video game 😉